Teaching Students at Risk

by
Jeffrey Berman

February 17, 2001

Can a reader's identification with a diseased or dying character in a story be so intense that it threatens to undermine his or her health? If so; what precautions should a teacher take to prevent students from becoming anxious; depressed; or suicidal? This essay begins with a brief discussion of three undergraduates who became at risk as a result of reading Kate Chopin's The Awakening; Sylvia Plath's The Bell Jar; and D.M. Thomas's The White Hotel. The essay then reports on the author's posting to subscribers of PSYART: asking them whether they ever encountered the phenomenon of "risky reading" in their classrooms. The essay ends with a discussion of the ways in which teachers can create a responsible pedagogy of risk that will allow students to confront painful and shameful subjects without becoming unduly vulnerable.

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I was sitting in my office two summers ago, during my regularly scheduled office hours, when Olivia walked hesitatingly in, appearing tired and somber. Something was wrong. She was one of twelve students taking English 447, the "Historical/Hysterical Imagination," which focused on the cultural and psychological implications of mental illness. Olivia had missed the previous three-hour class, her first absence. A few days earlier she had sat in class, her usual animated self. An excellent student, she had turned in an A essay the preceding week on Kate Chopin's novel The Awakening, a story about a young woman's depression, disillusionment, and suicide. Now the student sitting in my office seemed as gloomy and incommunicative as Chopin's protagonist. For a few seconds Olivia remained silent, and I looked at her, anticipating the worst. Was there a death in the family? A serious illness? A breakup in a relationship? When she finally spoke, she told me that she was feeling anxious and depressed, not for any of the reasons that I guessed, but because of the two novels we had just read, The Awakening and Sylvia Plath's The Bell Jar, both of which, she said, felt like receiving a one-two punch. Olivia had become at risk as a result of reading these novels, and I suddenly was confronted with the question every literature teacher must face sooner or later: how to respond to a student's crisis.

Chrissy: "People Do Not Often Think of the Consequences
of Reading Violent Disturbing Material When You Are Older"

I wasn't entirely surprised by Olivia's response, for two months earlier, another student taking English 447, Chrissy, told me during a conference at the end of the spring semester that she had experienced nightmares and insomnia while reading D.M. Thomas's The White Hotel. Chrissy was horrified by the novel's graphic description of the heroine's rape and murder at the infamous Babi Yar in Kiev during World War II. She told me that The White Hotel was not the first book that had this effect on her, and she agreed to my request to write a brief essay describing when the problem first occurred. She noted in her essay that although reading has always been one of her greatest pleasures, she learned when she was young that she could not read certain books--not because they were too difficult but because they prevented her from sleeping at night. The first story that evoked this response was The Diary of Anne Frank, which she read when she was ten. "As I read the book I noticed that I was more afraid of the dark than normal. I had trouble sleeping, and often had nightmares about being hunted and captured by the Nazis. I would hear sirens in my sleep, and at night, once it was dark outside I would sometimes have the sensation of being stalked like some kind of prey."* She never finished the book. In junior high and high school she was able to avoid texts with a disturbing content, but when she went to college and began studying the Holocaust, the nightmares returned. Reading an account of the murder of the Romanovs literally made her sick. "The authors went on to say how the bodies were first dropped down a mine shaft and then later relocated to another grave by train tracks. They went into minute detail of how these bodies must have looked, not leaving out one detail, making sure it was understood that no one could have possibly survived the carnage. For days after this I would be able to picture the bloated bodies with their matted hair turned black from all the blood, and feel like I might just hurl."

The White Hotel was wrenching for Chrissy because she participated in and experienced the heroine's gruesome death. "As Lisa tried desperately to save herself and her son, I was reminded of my nightmares where I was being hunted and I had to try to outwit and escape those who would capture and kill me. Every part of that section from the rape to the description of the layers and layers of murdered corpses in that ravine sickened and frightened me." She finished the novel but was angered that she was forced to read it. "People do not often think of the consequences of reading violent disturbing material when you are older." Nor did she think that her response was unusual. "Anyone who can read a book as though they are seeing a movie in their mind could be similarly affected, and I think for this reason teachers ought to be careful in what they assign. Professors ought not take it for granted that because students are past a certain age that they can handle anything. Why should anyone assume that at a certain age you become jaded enough that you are unaffected by death?"

Chrissy's vivid imagination allowed her to visualize every gruesome detail in The White Hotel. Her identification with the doomed characters was so intense that she too felt hunted and trapped. It was as if the boundaries between self and other, and life and art, had vanished. She must have known while reading The White Hotel that she could have closed the book at any time, but the story seemed to invade her unconscious mind, evoking a nightmare from which she could not escape. Reading the story literally sickened her, and she experienced intense anxiety, gastrointestinal symptoms, and agoraphobia. She observed elsewhere in her essay that reading novels or seeing films containing gratuitous violence is not nearly as troubling to her as art depicting historical violence, such as Schindler's List: "movies like this are so awful, and true. I think that part of the reason these things disturb me is because they happened, and that is the most disturbing thing of all."

History cannot be banished from literature simply because it is disturbing, but should teachers take special precautions when assigning novels like The White Hotel? Should teachers warn their students that some of them might find class readings painful, even traumatic? I had neglected to do this in Chrissy's class. But how representative is her response? Do a significant number of college students find reading so upsetting that they actually become physically and psychologically ill? I decided to pursue the question further. A month later, while teaching the same course in summer school, I informed the students that some of the books on the syllabus might place them at risk and urged them to speak to me if this occurred. I also told them that they could write their formal essay on this topic if they found themselves becoming at risk. Within a few weeks two of the twelve undergraduates came to my office, separately, and revealed that they felt anxious and depressed while reading The Awakening and The Bell Jar.

Justine: Do The Awakening and The Bell Jar Place Readers at Risk?

Justine was one of these students, and she describeD in her essay how reading both novels was almost more than she could endure. She began by noting that she was depressed and lonely the preceding summer. "My grandmother's death, being isolated in the dorm, attempting to write at the time what seemed the most impossible paper to make up an incomplete, most of the summer away from my boyfriend, and fear that I had a sexually transmitted disease drove me to putting an iron in the bath tub in an attempt to electrocute myself (grateful then and now that the cord could not reach an outlet). I turned my incomplete in on time and it turned out I did not have a sexually transmitted disease."

With her mother's help Justine recovered, but this summer she started to feel depressed again, particularly when she identified with Esther Greenwood's symptoms. "The Bell Jar made me think about suicide more clearly because of its realness in terms of Esther's suicide attempts. I hate to admit the similarities between us like our age, being English majors, having difficulty writing, knowing what you want to do but no motivation to do it, and paranoia among other things. I laughed when Esther looked up depression and saw her symptoms matched. Looking up illnesses got the better of me last summer when I thought I had a sexually transmitted disease. I was surfing the internet and reading anything I could find out about the disease. Many of the symptoms described what I thought I had. I think I made myself think I had them." Justine also identified with Edna Pontellier's feeling "as if life were passing by, leaving its promise broken and unfulfilled" (The Awakening 70). Justine acknowledged later in the essay that she has more resources than either Esther or Edna, including a supportive family. She concluded that "it is important when a teacher assigns The Awakening, The Bell Jar, and similar books to take precautions. He or she should be prepared if a student is feeling depressed or suicidal during and after reading these novels. Talking to their students before and after is therapeutic and essential in assuring that students do not get the wrong message. If a student is showing signs of serious illness they should be directed to the appropriate practitioners."

Justine found herself at risk as a result of identifying with two fictional characters whose feelings of loneliness, anxiety, and sadness paralleled her own. The knowledge that Sylvia Plath committed suicide shortly after writing The Bell Jar made the novel more frightening to her. Justine never romanticized suicide, but she described how depression might lead to constricted thinking. Rather than broadening her perspective, as literature often does, reading seemed to narrow her vision, at least temporarily.

Justine's essay raises several important pedagogical questions. Are female students--who typically experience higher incidences of depression than men--at greater risk when reading psychological stories about vulnerable female characters? Might the act of reading contribute to a student's feelings of isolation and hopelessness? Should teachers receive special training so that they can identify those students who might become at risk when reading stories about depression? Should students be encouraged to write about these experiences, as Justine did?

Justine allowed me to read her essay anonymously to her classmates, and she later observed that she was glad she wrote on the topic despite the fact that it was painful to hear her words read aloud. "I believe that I am stronger after writing that paper. Writing can be very therapeutic. As I wrote I realized that there were things that I never thought about and some I gave second thoughts about in regards to my depression and near attempt at suicide. Questions come to mind like what if my mother was not there during that crucial time? Or what if the cord in the iron did reach an outlet? I still get upset remembering how low I had been. But I am glad that I am even able to write about that experience. Sharing one's experiences is beneficial to those that have gone through the same thing because it lets them know they are not alone."

Olivia: A Fortnight with Insomnia and the Bell Jar

Olivia was the other student who found herself at risk in my summer school course, and as she sat in my office, she told me that The Awakening and The Bell Jar unexpectedly reminded her of the depression she experienced five years earlier, when she was sixteen. The old feelings of melancholy had returned in the last two weeks, engulfing her in sadness. Alarmed by her appearance, I suggested that she visit the university counseling center, but she replied, "My parents would kill me if they knew I was seeing a therapist. I don't stigmatize mental illness in others, but I do in myself." We spoke for a few minutes, and then I made an unusual offer to her. Instead of taking the final exam, would she prefer to write an essay describing how the two novels placed her at risk? I told her that the reader-response essay would probably require more work than the final exam but that it might enable her to understand the novels' impact on her life. I didn't know whether writing about this topic would help or hurt her, but she readily agreed to my suggestion and a week later submitted a detailed account of her experience reading the two novels.

Olivia's essay described her growing fear that her past depression was returning. Reading The Awakening, she found her sleep patterns disturbed and, like Edna, began to lose herself in "mazes of inward contemplation" (57). Nor did the mood lift by sunrise. "Surrendering and acknowledging defeat, I rolled out of my bed and sat Indian style on the floor. I stayed there for a while, limp of energy. It was eight a.m. (which is early for a college student). I felt claustrophobic, though I was in the middle of the room, with nothing around me. Sitting there quietly, I felt cornered, cramped, suffocated. Suddenly, I thought of Esther's bell jar, her type of 'indescribable oppression.' I could sense the boundaries of the transparent bell-shaped glass; within it, I was trapped in this feeling, this mood of unsettlement and extreme anxiety. This was the way I felt in high school, not even comfortable in my own skin."

Olivia's mood lasted for the two weeks in which we discussed The Awakening and The Bell Jar. She viewed the novels not only as "fascinations" but as "entrapments" since Edna and Esther conjure up a world from which she tried so hard to escape. "Edna's societal oppression, insomnia, feelings of depression, her struggles with womanhood and individuality, and finally her love of music branded the deepest impressions in my mind." Olivia found herself becoming like a "zombie, walking along, mechanically," and she could see no difference between herself and Edna. Olivia described living in what she calls a "muted state" in which she became the "observer and the analyzer," watching the people around me, in the alien world." She knew that she must separate herself from Edna's story in order to preserve her health.

Upon finishing The Awakening, Olivia began The Bell Jar, which proved to be far more disturbing. "Knowing that Plath committed suicide after the completion of this novel casts a very dark cloud around depression and recovery from it. With Plath's suicide, Esther's character lays void. The trace of hope developed at the end of the story, with Esther being reviewed by the committee, is pushed aside, when in real life the bell jar could not be lifted from Plath." Olivia believed that everything she felt during her reading--insomnia, confusion, loneliness, hopelessness, nothingness--was condensed by Plath into two words--bell jar. Though still wary, Olivia felt the bell jar lift as the course ended. "I am in my soul's summer day, thankfully. I find myself fortunate that I am in such a positive stage in my life and that this was only a short summer session. I am also thankful that the precautions the professor took were well-suited, and very congenial with a sympathetic approach. He left the door wide open and gave a fair warning of what may happen. His availability comforted me while I was trapped in this spell. Though I experienced such haunting things, I am glad to have read the material. I know that I am not alone. Nor does this hinder me from putting The Awakening on my shelf as one of my favorite novels."

Like Justine, Olivia found herself identifying so closely with the suicidal characters in The Awakening and The Bell Jar that she began experiencing nearly all of their symptoms of depression. A clinical psychologist might infer from her symptoms that reading the two novels produced an anxiety or panic attack. Olivia's description of "feel[ing] myself drifting away to the background, merely an observer" recalls William Styron's depiction in Darkness Visible (1990) of his suicidal depression: the "sense of being accompanied by a second self--a wraithlike observer who, not sharing the dementia of his double, is able to watch with dispassionate curiosity as his companion struggles against the oncoming disaster, or decides to embrace it" (64). Olivia never mentioned feeling suicidal, but her description of a wraithlike observer suggests a form of psychological splitting in which one part of the self gazes impersonally at another part of the self that is immobilized by anxiety or fear. She thus re-experienced the anxiety of a younger, vulnerable self whom she thought she had safely outgrown.

Olivia acknowledged that writing was one of the "tools" that allowed her to emerge from the bell jar when it first descended at age sixteen. She told me in a conference after the semester ended that writing also helped her escape from the depression induced by reading The Awakening and The Bell Jar. When I asked her what would have happened if she didn't have the opportunity to write about becoming at risk, she replied that her anxiety and confusion might have lasted longer. She felt that writing the essay was therapeutic because it enabled her to discover not only the similarities but also the differences between her own situation and those of the fictional characters.

I have cited Chrissy's, Justine's, and Olivia's essays to demonstrate that readers may find themselves becoming at risk in a college literature course. Their essays are cautionary tales for all educators. This does not mean that teachers should avoid asking their students to read emotionally charged texts, but it does mean that risks cannot be eliminated from the classroom. We generally assume that reading and writing are parallel activities leading to empowerment, but in some cases the former may induce a crisis that the latter may help to resolve.

PSYART Responses to Risky Reading

Do college teachers inform their students that they might become at risk when reading literature? If so, what precautions do teachers take to minimize these risks? Have students in other college courses experienced reactions described by Chrissy, Justine, and Olivia? To pursue these questions, I decided to send a posting to the literature- and- psychology electronic listserve PSYART, moderated by Norman Holland at the University of Florida. I asked subscribers if they had encountered the phenomenon of "risky reading" in their own classrooms, as I had in mine, and whether they had ever themselves become at risk while reading fiction or nonfiction. I invited them to e-mail me either through PSYART, which has over 850 subscribers, or through a private e-mail. My query produced a lively and prolonged discussion, with more than twenty people participating. Respondents were generally divided into two positions, those who objected to the specter of censorship they inferred from my question, and those who believed that literature could indeed pose a threat to certain readers.

Eight people feared the censorship implications of my query and questioned whether teachers "[can] place ideas in people's heads." They implied that only a severely disturbed student might become at risk from reading. Interestingly, all eight respondents "went public" by posting their responses to everyone on the listserv. Allison White Ohlinger referred to the highly publicized law suits in the past twenty years that alleged a causal relationship between song lyrics and violent behavior in teenagers. "Anyone genuinely at risk of suicide might 'go over the edge' after reading a book or listening to a song that glamorized death, but such a person might also be influenced by seeing a vase of dead flowers, passing a funeral cortege, or hearing of the death of a celebrity. No one could reasonably blame the victim's suicide on the object or occurrence, but on their condition of being suicidal--just as assigned course reading can't be the sole cause of students' reported feelings of paranoia and depression, just because the reading is 'risky.'" Norman Holland cited being contacted years earlier by a woman who, convinced that her son's suicide was caused by reading Romeo and Juliet, wanted the play banned from the high school reading list. Another brought up a more timely example of censorship, the attempt to ban the Harry Potter books in England because of the belief that they are violent and therefore not fitting for children. All of these respondents objected to the idea that teachers should avoid challenging their students' thinking. As Randy Fromm observed, "I find the idea that we should somehow coddle students who appear unequipped to meet life's challenges antithetical to the aims of education, at least so far as I see them. Where else are they to get or develop the principles by which they will live in their chosen future if not through tough challenges of their fundamental beliefs."

Two respondents in this group implied that some of my students might have become at risk through the power of suggestion: that is, because I had alerted them in advance to this possibility. "Maybe women are more responsive to suggestion," Patricia Sloane wrote. "When I was the age of your students, I went into therapy with a Jungian analyst who spent the first session telling me how important dreams are. I sure did dream up a blue streak after that, maybe because I wanted to do what I thought was expected of me." John Buksbazen agreed that the power of suggestion might explain this phenomenon:

While there are certainly books which can affect some readers traumatically, we should also consider the role of suggestion in Jeff's "alerting" his undergrads to an experience which several appeared to then have. Such a communication, however well-meant as I'm sure it was, carries with it an embedded and possibly hypnotically-influential message, which, potentiated by the asymmetrical teacher-student relationship, might quite possibly precipitate an adverse reaction, especially where such a predisposition is present in the student-reader. I think Jeff is justified in his concern about the student vulnerability, but I would urge all of us in similar circumstances to be specially aware of the unconscious communication phenomena we may create by the ways in which we formulate our metacommunications.

For every respondent troubled by the censorship implications of my query, another acknowledged that literature could pose a serious threat to readers. One of the most interesting responses came from Claire Kahane:

I have had the experience you describe for the last several years, not surprisingly, since I have been teaching Holocaust narrative and trauma. The first time I presented traumatic material, a girl ran out of my class crying. That hasn't happened again, since I have become more sensitive to the issues of teaching this kind of risky reading. And certainly, as you suggest in your query, I and my colleague who also teaches Holocaust representation have ourselves been deeply disturbed by the material we engage. Actually, to have a distance on traumatic representations is in a sense to declare their failure. Yet a distance must be had in order to talk about these texts in a classroom setting.

Professor Kahane noted in another PSYART posting that Primo Levi admitted becoming at risk while translating Franz Kafka's The Trial:

Rightly or wrongly, consciously or not, I have always tried to move from obscurity to clarity in my writings. . . . I take up dirty water, I throw it out purified, transparent, almost sterile. Kafka takes the opposite path. He disappears in the depths . . . He never filters what presents itself to him. The reader feels polluted. . . . Through reading Kafka, I discovered that I had unconscious defenses. These defenses collapsed when I began to translate. I found myself profoundly bound to the fate of Joseph K. Like Joseph K., I began to accuse myself. (Qtd. in Rosenblum 17)

During the same week in which I received responses to my PSYART query, an article appeared in The Wall Street Journal about a new and growing phenomenon, "cyberchondria," one that had afflicted Justine a year earlier :

The Internet is making it easier than ever to be a hypochondriac. The anxious used to have to trudge to the library to research symptoms in tomes like the Physicians' Desk Reference or the Merck Manual. Now, the explosion of medical information on the Web--there are an estimated 15,000 health-related Web sites--has provided a powerful new tool for wired worrywarts, including the "worried well," on which they can pore over highly technical medical journals and commiserate electronically from their homes. (Reprinted in the Albany Times-Union, 10 October 1999)

Yet one does not have to be a hypochondriac to experience intense anxiety or depression while reading. Apart from the PSYARTers who responded to my query by relating examples of their students becoming distraught over classroom readings, five people spoke about their own emotional reactions to literature:

I don't respond to postings through the PSYART-list, but your letter affected me. I took an advanced degree in post-War literature, knowing I was drawn to the writing of this period, but not really scrutinising why. During the one-year stint of reading volumes for my qualifying exams, mostly works from survivors, I fell into one hellova depression. This phase of revaluation of my aims in persuing an academic career occasioned my recognition that I, as a bastard of the first order ("Mischling ersten Grades," a legal term), would have been exterminated and surely by many of those who were my colleagues. This statement was/is not hyperbolic. I did not at the time or subsequently share this recognition with colleagues. Or with family.

I guess the reason I write is to say that the literature only opened me to realising what I knew very personally. It did not invoke this response solely by being "out there." And, of course, there is the beautiful anonymity of writing someone "out there" who will register this, who appreciates what the experience is.

* * *

I hope you'll forgive the rushed quality of my response--I'm late for class but upon reading your entry felt compelled to write immediately. I'm a doctoral student and in a course on Biography and the Arts we did a lot of in-depth readings of Virginia Woolf. My train rides home after class at night were almost always quite tearful! We were reading To the Lighthouse and Mrs. Dalloway, and yes--I became pretty depressed and withdrawn during this time (although it yielded a whole bunch of insightful journal entries).

* * *

When I was a freshman in college (several years ago) I had begun to read a lot of Kafka. The Trial, especially, had a profound effect on me, and to some extent must have been responsible for grounding me into a deep depression and overall discomfort with the world. I have read The Trial since then and do not experience the same states of mind. Some of the contributing factors must have been that I was reading Kafka on my own, without the guidance or structure of a class, and that I was relatively immature at that time and could not readily distinguish the fiction of the work from the message of a stinging condemnation of existence.

* * *

I read The Bell Jar when I was probably too young (mid-teens) or too impressionable or both. It affected me a great deal. It was the summer of my "moodiness." Never thought to trace it to the book. Interesting. Will have to reread it.

* * *

I agree it [literature] can work as a triggering device. I don't think it was any coincidence that my own mental breakdown--from which I have recovered nicely--was due in part to my reading Nietzsche's "My Sister and I," which was written while he was in a mental hospital.

Significantly, four of the five responses were e-mailed to me alone rather than to the entire PSYART forum. The reason? I suspect that readers feel uncomfortable acknowledging that literature can be a risky art form, even (or especially) to those who later devote their lives to teaching and writing. Readers are reluctant to admit that literature can have powerful consequences that are not always anticipated or desired. They may have also feared that revealing their names publicly would hurt their careers.

Traumatic Art

It should not be surprising that reading can become painful, even traumatic, to some students. In Surviving Literary Suicide I document the ways in which the self-inflicted deaths of Virginia Woolf, Ernest Hemingway, Sylvia Plath, and Anne Sexton have affected readers. Literature can, in an Aristotelian sense, "purge" readers of toxic emotions and lead to catharsis, but it can also, in a Platonic sense, "infect" readers and lead to illness. I don't mean to suggest here a simple stimulus-response model of reading. Rather, a reader's identification with a fantasy, fear, or conflict in a text may be so powerful and disturbing that it threatens to overwhelm his or her defenses. The most striking example of the "infection" or "contagion" theory of literature is The Sufferings of Young Werther (1774), Goethe's confessional novel about a passionate young man who kills himself because of unrequited love:

Goethe based some of the details of Werther's suicide on a friend who took his own life, but the novelist was also writing about his own tormented feelings. He was actively suicidal when writing the story and "even kept a dagger at his bedside and made repeated attempts to plunge it into his breast" (Steinhauer 20). Goethe may not have romanticized suicide to the extent that Werther does, but he identifies so closely with his hero that he blurs the separation between author and character. Werther views himself as a Christ-like martyr and, before shooting himself, tells his beloved Lotte, who was modeled closely on Goethe's Charlotte, that she will be better off without him. Werther also offers a long philosophical justification of suicide, claiming that it leads to eternal freedom.

Goethe was later embarrassed by the novel and distressed that it provoked numerous readers to imitate the event. "Sentimental young men sported Werther's costume: blue coat and yellow trousers and vest; some lovelorn creatures followed his example and committed suicide with copies of the novel in their pockets" (Steinhauer 24). Goethe healed himself through the telling of the story and lived a long and productive life, but this consolation came too late for those readers whose identification with his suicidal hero proved fatal. (Berman 26)

The suicide rate always jumps when a famous actor, actress, or rock singer takes his or her own life. Sociologist David Phillips, who coined the expression "the Werther effect," has estimated that celebrity suicides raise the suicide effect by an average of 1 percent for about a month. "The largest increases in British and American suicides occurred after the deaths of Marilyn Monroe, the actress, and Stephen Ward, the British osteopath involved in the Profumo affairs. In the United States, suicides increased by 12 % in the month after Marilyn Monroe's death and by 10 % in England and Wales" (Phillips 306). But it is not simply the Werther effect that comes into play here: readers or viewers can be overwhelmed by any work of art. For example, Stephen Spielberg's 1998 film Saving Private Ryan, which graphically reenacts the D-Day invasion at Omaha Beach in Normandy, traumatized not only soldiers of World War II but of Korea, Vietnam, and the Persian Gulf, awakening long-repressed memories of combat. "Across the country, veterans' hospitals have been inundated with calls from men seeking help coping with disturbing memories uncovered by the movie's realism. In some cases, the film's stark portrayal of torn flesh and frightened soldiers watching their friends die triggered post-traumatic stress disorder in veterans who had never experienced such difficulties before, counselors said" (Albany Times-Union, 31 July 1998).

One does not usually think of The Awakening or The Bell Jar as implicated in the violent effects of a war film, but young adults who are or have been depressed or suicidal may read these novels and re-experience heightened fantasies of self-martyrdom, particularly if the stories seem to speak to their own age and culture. A play like Hamlet, with its soliloquizing on suicide, may not be nearly as disturbing to a young adult as a story like The Bell Jar, to which so many contemporary readers relate. Nor are we talking about an insignificant number of college or high school students who may be at risk. As Kay Redfield Jamison observes in her 1999 book, Night Falls Fast: Understanding Suicide, the "1995 National College Health Risk Behavior Survey, conducted by the Centers for Disease Control and Prevention, found that one in ten college students had seriously considered suicide during the year prior to the survey; most had gone so far as to draw up a plan" (21). The figures for high school students surveyed in 1997 were even more troubling: one in five students had seriously considered suicide in the preceding year; most had drawn up a suicide plan. Jamison adds that "[o]ther research, conducted in Europe and Africa as well as in the United States, has shown that mild to severe thoughts of suicide are common, occurring in 20 to 65 percent of college students" (36). Jamison cites research done by Cynthia Pfeffer, a Cornell University child psychiatrist, indicating that "more than 10 percent of a sample of 'normal' schoolchildren, that is, children with no history of psychiatric symptoms or illnesses, report suicidal impulses" (38). Jamison, a Professor of Psychiatry at Johns Hopkins University, has written eloquently about the devastating personal and interpersonal consequences of suicide; her best-selling memoir, An Unquiet Mind, chronicles her own lifelong struggle with manic depressive illness and suicidal thinking. According to the latest New York Times/CBS poll, 46 percent of teenagers knew someone their own age who had attempted or completed suicide. Many more girls knew about suicide attempts than boys: 56 percent compared with 37 percent (New York Times, 20 October 1999).

To acknowledge these figures is not to argue for censorship or for the "coddling" of students but rather to recognize the power of literature for both good and--quite literally--ill. A striking confirmation of this power is hinted at by Andrew Solomon in his review of Night Falls Fast:

Jamison notes that suicide is catching, and avers that one death often enables many others, as localized suicide epidemics have indicated. If suicide is contagious, is not Jamison's book itself a potential source of infection? Her evocations of the suicidal mind invite too much empathy at times; her eloquence can be dangerous, and I felt a will to self-destruction rise in me as I read on. If the material is somewhat toxic for the reader, however, it must have been more poisonous for the author. It is something to have lived through the writing of this book; it took at least as much courage to write "Night Falls Fast" as it does to live through the woe that has afflicted Jamison's living subjects. (New York Times Book Review, 24 October 1999)

Given the number of people who may find their defenses weakened or overwhelmed by the act of reading, teachers need to rethink pedagogical strategies designed to "destabilize" students in the name of social and political reform. To cite one example, Gregory Jay invokes Lacanian theory to argue that "the teacher's task is to undo certainty":

A pedagogy of the unconscious must dislocate fixed desires rather than feed us what we think we want to know. Unfortunately, this means that the teacher's task is to make the student ill (which we often do unknowingly anyway). Where the psychoanalyst seeks to stabilize a shattered self, the pedagogue hopes to unsettle the complacency and conceptual identities of the student. Education becomes subjective in the sense that the student experiences his or her existence as a being subjected to various discourses, including that of the teacher. The disturbance that ensues includes the split between the self-as-subject and the subject-of-knowledge, since the latter comes into being in skeptical reflections on the former--even to the point of finally doubting the value of such reflection. Like psychoanalysis, education can only begin with self-doubt, and its disciplinary self-analyses should be interminable. (790)

It is one thing to "unsettle the complacency and conceptual identities of the student" but quite another to destabilize identity to the point where a student becomes clinically at risk. Yet this is precisely the pedagogical strategy advocated by Jay, who casually informs us in a parenthesis that teachers "often" make their students ill. He may be using illness as a metaphor, but the word takes on a much more frightening reality in an age in which, according to one Harvard Medical School researcher, an estimated 37 percent of Americans aged 15 to 24, many of whom are college students, have a diagnosable mental illness (cited in "Treating Mental Illness in Students: A New Strategy," Chronicle of Higher Education, 16 June 2000).

The Teacher's Responsibility

If reading or writing may be dangerous under certain conditions, how can teachers challenge students without shattering their identity? To begin with, they can alert their students to the possibility that some of them might respond to a classroom reading or writing assignment the way in which some people react to a flu vaccination: namely, by developing symptoms of the illness against which they have been inoculated. Generally these symptoms are mild-to-moderate in intensity and disappear in a few days. While it is true, as two respondents to my PSYART query noted, that alerting students to the possibility that they might become at risk may induce some symptoms that would otherwise not occur, literature works precisely through the power of suggestion. A novel like The Bell Jar may be so real to certain readers that they cannot help imagining themselves suffering from the protagonist's fears and maladies. Just as physicians and pharmacists routinely inform their patients of possible adverse reactions to a drug, so might teachers alert their students to the untoward consequences of a novel or a writing assignment. Even then, it is not always possible to detect when a student is at risk. Reading Olivia's first essay on The Awakening in light of her second one, I could not infer that she was at risk. Nor would I have known that Justine was at risk had it not been for my conversation with Chrissy, who sensitized me to risky reading. Yet it is not unusual for students to tell a teacher that they are "having problems" with a reading or writing assignment, and a simple question may help students to reveal when these are "emotional" problems. It doesn't require much time or effort to alert students to the possibility that they might become at risk. The present strategy of "Don't ask, don't tell" is no more effective in education than in the military.

The knowledge that others have experienced and survived depression can be comforting, as both Justine and Olivia told me. Memoirs like William Styron's Darkness Visible and Kay Redfield Jamison's An Unquiet Mind affirm the possibility of survival. These narratives are especially welcome when reading novels and poems by Virginia Woolf, Ernest Hemingway, Sylvia Plath, and Anne Sexton, all of whom suffered from severe clinical depression or manic depression and lived in an age when effective treatments were not available. Students need to know that major advances in psychopharmacology and psychotherapy have made these illnesses far more treatable than in the past.

Beyond this, teachers can make themselves available to students who become anxious or depressed from a reading or writing assignment. They can try to be sensitive to the many students who, sitting alertly or perhaps not-so-alertly in their classrooms, struggle with personal problems that seem overwhelming to them. Literature teachers can play a vital role in suicide prevention, for they are among the first to realize from a diary or personal essay that a student may be depressed. Teachers should be able to recognize the signs of suicide so that they can make appropriate referrals to university counseling services. I agree with Mark Bracher's recommendation that "[e]ducators in all roles--from teachers and advisors to administrators and policy-makers-should receive training that allows them to understand, recognize, anticipate, avoid, and (when necessary) counteract the numerous ways in which the various aspects of education can threaten students' identities and thus disrupt the various ego functions essential to learning" (180).

Teachers can be caring without becoming caretakers. They are not trained to be psychiatrists, but they should avoid glorifying or stigmatizing mental illness and remain hopeful about the power of knowledge in all its educational and therapeutic implications. Teachers' positive or negative attitudes toward education strongly influence their students' attitudes. Hope and hopelessness are contagious. As Jamison states in Night Falls Fast, "hopelessness is strongly related to eventual suicide in both depressed inpatients and outpatients. . . . People seem to be able to bear or tolerate depression as long as there is the belief that things will improve. If that belief cracks or disappears, suicide becomes the option of choice" (94).

Hope, or the belief in positive expectations, is the force behind the powerful "placebo" effect, a phenomenon that has attracted increasing scientific and medical inquiry. Many studies have shown that placebos, which are pharmacologically inert substances, are associated with a 50 percent reduction of pain in about one-third of patients suffering from a wide range of illnesses (Frank 136). Favorable expectations often lead to favorable conclusions--hence, the importance of hope. Like the physician, psychotherapist, and minister, the teacher who maintains a hopeful attitude is more likely to achieve positive results than one with a less hopeful attitude. To remain hopeful is not to be naive about the often terrifying reality of mental illness but rather to recognize that most people survive the experience. Those who live to write about it can play a crucial role in the survival of others. Teachers can also play a significant role by helping to make literature come alive for their students and serving, when necessary, as part of an educational support system when a student's identity is threatened by a text.

Perhaps this is what Olivia was hinting at when she refers to her teacher as "the doctor" at the beginning of her essay. She did not expect or want any medical advice from him but simply the assurance that she would be able to talk to him about her "journey through the historical/hysterical imagination." All she wanted, as she writes at the end of her essay, was for her teacher to leave his office door wide open and to give a fair warning about what might happen in the course. "His availability comforted me while I was trapped in this spell. Though I experienced such haunting things, I am glad to have read the material. I know that I am not alone."

Finally, we should acknowledge that some risks cannot be avoided and may actually contribute to health and well-being. Reading and writing can alert us to inner conflicts that may lie dormant for many years before erupting explosively. As Charles Paine observes in The Resistant Writer, regardless of whether we take a modernist or postmodernist approach to the body's complex immune system, reading and writing can help students to uncover and work through serious conflicts or imbalances. "If our immune systems are to be flexible, they must be clever enough (not just tough enough) to enter risky situations (the world is a risky place of germs and disease), where contagion can never be prevented but only responded to" (17).

Psychological research lends support to this conclusion. In Jerome Frank's words, "heat that melts wax tempers steel. Despite the enormous popular health literature on the importance of avoiding stress, most moderate stresses in fact promote health. To use another analogy, life, like a violin string, is no good unless it is stretched. Some highly successful people may even seek stress to enjoy the triumph of mastering it" (22). Ronnie Janoff-Bulman agrees. "There is some evidence that prior stressors may inoculate an individual against extreme trauma following negative life events. Generally, these appear to be stressors of moderate magnitude, sufficient to challenge and even slowly change some assumptions in the direction of decreased naivete" (90). In this context, Mary Ellen Elkins's insightful response to my PSYART query is worth quoting:

As has been pointed out by others, there are life experiences, some dangerous, that we unconsciously bring to our reading. When these are accidentally brought to consciousness by the act of reading, a student would feel the panic and anxiety that Jeff has described. This confrontation can feel so dangerous to our psychic health that it may seem better to hide from it than to advance, unaided, toward what appears to be certain annihilation. In other words, are there not psychological equivalents to finding oneself accidentally faced with an angry Grizzly Bear? Perhaps a teacher cannot offer a student a gun or its psychological equivalent in such a situation, but he can offer a means of survival: Play dead but only until the Grizzly runs away, i.e., the immediate danger is over, then get to safety and write about the experience--deal with what's happened.

By inviting students to write about their experience, the teacher validates the students' responses and, by example, teaches students to value and embrace their experience, negative or otherwise, and to engage a deeper or more whole awareness of their feelings. The teacher also conveys a message of confidence: "I know there are terrors but I also know that we humans can face and survive them and come out the better for it. That is the way towards life." In acknowledging pain that we are presented with and telling the student he can write about it, we validate and open a door to a constructive act, then we can let go, we do not step over any boundaries, we do not coddle nor do we assume the mantle of psychologist. Is this not a valid response for a non-psychologist to make? Perhaps it will be enough; if not, the teacher can recommend professional help.

In short, teachers need to discover a responsible pedagogy of risk that will allow students to confront painful or shameful subjects without becoming vulnerable. "Risk is essential to growing up," Stephen Smith observes emphatically, and it can lead to self-direction and self-confidence in children and adults (181). Risk and fear are "twin themes of life," John Urquhart and Klaus Heilmann suggest: "Fear drives us to shun risk, yet risk accompanies any action, however trivial. To grasp opportunity, one must act, and, in acting, one incurs risk: opportunity and risk cannot be separated, and no goal can be attained without accepting risk" (ix). This pedagogy of risk will encourage students to tap into the many therapeutic and transformative powers of reading and writing while minimizing harmful side effects. A pedagogy of risk will also allow students to write about fears and conflicts and identify survival strategies. In this way, students like Olivia, Justine, and Chrissy will be able to decide for themselves how best to strike a balance between fear and opportunity.

Note

* I have received written permission to quote from the three students whose writings appear here, as well as permission from the University at Albany Institutional Review Board, which must approve all human research. I have also received permission to use the PSYART responses quoted later in this essay. Back to the main text?

Jay, Gregory. "The Subject of Pedagogy: Lessons in Psychoanalysis and Politics." College English 49 (1987): 785-800.

Paine, Charles. The Resistant Writer: Rhetoric as Immunity, 1850 to the Present. New York: State University of New York Press, 1999.

Phillips, David. "The Influence of Suggestion on Suicide: Substantive and Theoretical Implications of the Werther Effect." American Sociological Review 39 (1974): 340-54. Rpt. In Essential Papers on Suicide, ed. John Maltsberger and Mark Goldblatt, 290-313. New York: New York University Press, 1996.